Q. I have three children – a healthy 2-year old and twin 9-year olds with severe Autism Spectrum Disorder. I recently took them grocery shopping, and when looking at the ingredients on a label, one of my twins disappeared. Luckily, the clerk at the front of the store found him wandering around and returned him to me. Unfortunately, this was not the first time this type of incident had happened. I need to be constantly vigilant about losing track of my autistic twins and my 2-year old. Like many parents, I am very concerned because both of my twins are non-verbal and something could happen to any one of my children. If one of my children really got lost, how would anyone who finds him or her know who he or she is and how to get in contact with the me?

A. Parents of young children and children with autism have many fears. Like Laura from our example, one of them is losing their child as they wander off to some place they are not familiar with.

It has long been known that children with autism spectrum disorder (ASD) have a tendency to take off on their own. In fact, in 2012, the journal Pediatrics published a study confirming the alarmingly high incidence of kids who wander. The study surveyed parents of 1,218 children with ASD, and found that 49% of children with ASD had wandered off at least once after the age of four. Of these, 24% were in places where they were at risk of drowning and 65% were in danger of injuries in traffic. The study pointed to “the urgent need to develop interventions to reduce the risk . . . [and] to support families dealing with this issue….”

Many industries have enjoyed success with QR (Quick Response) codes, and they are now being used by parents, as well, as a way to track wandering children with ASD. QR codes (two dimensional square codes which can be read by smart phones) are an inexpensive way to share a lot of information in a small area.

Small tags on most medic-alert bracelets do not typically have enough space to give all the necessary information. A bracelet imprinted with a QR code could link to a website explaining an autistic child’s medical condition, medications, alternate emergency contacts, insurance information and any other data about that child, including how to calm them down. If the person who finds the wandering child does not have a smart phone handy, the bracelet should also be imprinted with the URL of a profile page about the child or a way to contact the parent.

QR codes (on bracelets, necklaces, keychains etc.) can also be used by caregivers of people with Alzheimer’s, dementia, Down syndrome, epilepsy and other conditions, as well. Emergency response personnel can just scan the QR codes and retrieve vital health information about seniors and others with special needs, and be able to locate contact information of family members of a disoriented senior with dementia. They can find out what medications are safe and what other procedures are needed to help seniors or those with special needs.

If you are technologically savvy, you can create your own free QR code for a child or senior who wanders, that links to any page you choose on the Internet, by visiting the Free QR code generator.

Do you or a family member have special needs? Twenty million American families have at least one member with special needs. Parents of those with special needs are tasked with planning for their children throughout their lifetime, as many of them will outlive their parents but might not be able to support themselves and live independently.

As a parent or guardian, you want to ensure that your child with special needs will remain financially secure even when you are no longer there to provide support. A Special Needs Trust is a vehicle that provides assets from which a disabled person can maintain his or her quality of life, while still remaining eligible for needs-based programs that will cover basic health and living expenses. Learn more at The Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. website, or call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for a no-cost consultation

It’s estimated that 5.4 million people in the United States have Alzheimer’s disease or another type of dementia, and about 70% of them live at home. For most seniors with dementia, staying at home is a common goal; however, it can pose certain risks and prove challenging for family caregivers.

A new study of more than 250 Baltimore residents (average age of 83) who are aging in place was published recently in the Journal of the American Geriatrics Society. Findings from the study were as follows:

90% of those surveyed need to address safety issues to remain at home, including things like fall risk management and wander risk management. Read our blog post, “Making Our Home Safe for Dad” for details about making your home safe and accessible.

More than 60 % had general health care and medical needs that went unaddressed. Many in the group had not been to their primary care physician in the last year or addressed issues like dental, vision and hearing problems.

About half of the participants did not have meaningful activities in their lives, including even simple activities around the house (e.g. folding towels, helping to make a salad, setting the table, etc.), so they did not feel engaged in daily life.

The researchers also found gaps in legal issues and advanced care planning for 48% of people surveyed. Several were still designated as having power of attorney for a spouse who was now their caregiver. To their surprise, the researchers found that people with the mildest dementia and least difficulty functioning had more unmet needs than people with severe impairment.

At the Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. (www.VirginiaElderLaw.com), our firm is dedicated to helping protect seniors and individuals with Alzheimer’s and other types of dementia by preserving dignity, quality of life, and financial security. If you have not done Long-Term Care Planning, Estate Planning, or Incapacity Planning (or had your Planning documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, call us at our Fairfax Elder Law office at 703-691-1888 or at our Fredericksburg Elder Law office at 540-479-1435 to make an appointment for a no-cost consultation.

People with Alzheimer’s often wait years after their symptoms first appear to seek evaluation and treatment. In fact, according to the Alzheimer’s Association, half of the people with Alzheimer’s don’t even know they have it. If you or a loved one are experiencing memory loss that disrupts daily life, experts stress the importance of early detection of Alzheimer’s and other forms of dementia, providing the chance to get the full benefit of treatment sooner and also to allow for future planning.

Tests already exist that allow doctors to get a baseline measurement of cognitive function in their patients in order to follow and track change over time. However, these tests are not generally administered at home or in a community setting, but in a medical setting. According to the January issue of The Journal of Neuropsychiatry and Clinical Neurosciences, the Self-Administered Gerocognitive Examination (SAGE test) can be administered at home or in group settings (such as health fairs), and has proven to be reliable.

Created by researchers at Ohio State University (OSU), SAGE was made available online this month and the resulting news coverage led to so many people trying to access the test that it crashed OSU’s web site. The website is now working again, and the test can be downloaded here. The Alzheimer’s Association, which does not typically recommend self-administered testing for Alzheimer’s, speaks highly of SAGE and its reliability.

To develop the test, researchers at OSU visited 45 community events where more than 1,000 people age 50 or older took one of four versions of SAGE. Participants were provided their score and written information about SAGE, and were advised to show it to their physician for interpretation and potential further evaluation based on their health history. All were told that this test represented their baseline to be compared to future re-testing by their physician.

The 22-question exam measures orientation, language, computation, visuospatial skills, problem solving, and memory. The average time to complete this four-page test is 10 to 15 minutes, but there’s no time limit. Sample questions include:

How many nickels are in 60 cents?

How are a watch and a ruler similar?

Write down the names of 12 animals.

What is today’s date?

Draw a large face of a clock and place in the numbers.

“What we found was the SAGE self-administered test correlated very well with detailed cognitive testing,” researcher Douglas Scharre said in a release. “If we can catch this cognitive change really early, then we can start potential treatments much earlier than without having this test.”

Keep in mind that the researchers themselves say that the test does not diagnose memory and thinking problems, such as Alzheimer’s disease. According to the Alzheimer’s Association website, a diagnosis is made through a complete assessment that considers all possible causes. The assessment includes medical history, a physical exam, a neurological exam, mental status test, genetic testing, and brain imaging. If this tool is validated by further research, it may then become a tool that allows doctors to get a baseline measurement of cognitive function in their patients, so they can then track these abilities and assess change over time.

If you decide to complete the SAGE test, keep in mind that there is no answer sheet provided for you to score yourself because there are multiple correct answers to many of the questions on the test. SAGE should be scored by your physician, so be sure to take the results to your primary care physician for evaluation. Your doctor will score it and interpret the results. If indicated, your doctor will order some tests, as described above, to further evaluate your symptoms or refer you for further evaluation. If your score does not indicate any need for further evaluation, your doctor can keep the test on file as a baseline for the future. That means you can take the test again in the future, and the doctor can see if there are any changes over time.

A diagnosis of Alzheimer’s disease is life-changing for both diagnosed individuals and those close to them. While it’s not easy to think about, if your loved one has recently been diagnosed with Alzheimer’s, it is imperative to make an appointment with a Certified Elder Law Attorney such as myself, to determine who to name to make legal, financial, and medical decisions when your loved one is no longer able to do so. In addition, if your loved one hasn’t done so already, it is also of utmost importance to determine how he or she will pay for long-term care without depleting the family’s hard-earned assets.

People with Alzheimer’s live on average four to eight years after they’re diagnosed, but some may live 20 years beyond their initial diagnosis. Do you have a loved one who is suffering from Alzheimer’s? Persons with Alzheimer’s and their families face special legal and financial needs. At the Fairfax and Fredericksburg Medicaid Planning Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones. If you have a loved one who is suffering from Alzheimer’s or any other type of dementia or memory lost, we can help you prepare for your future financial and long-term care needs. We help protect the family’s hard-earned assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. Please contact The Law Firm of Evan H. Farr, P.C. as soon as possible at our Fairfax Elder Law office at 703-691-1888 or at our Fredericksburg Elder Law office at 540-479-1435 to schedule your appointment for our no-cost consultation.

By John Dedon
In the estate tax world, 2013 ended in stark contrast to the frantic planning during 2012. 2013 marked a return to fundamental estate planning; namely, using Wills, Revocable Trusts, Powers…

By John Dedon
In the estate tax world, 2013 ended in stark contrast to the frantic planning during 2012. 2013 marked a return to fundamental estate planning; namely, using Wills, Revocable Trusts, Powers…

By John Dedon
In the estate tax world, 2013 ended in stark contrast to the frantic planning during 2012. 2013 marked a return to fundamental estate planning; namely, using Wills, Revocable Trusts, Powers…

By John Dedon
In the estate tax world, 2013 ended in stark contrast to the frantic planning during 2012. 2013 marked a return to fundamental estate planning; namely, using Wills, Revocable Trusts, Powers…

By John Dedon
In the estate tax world, 2013 ended in stark contrast to the frantic planning during 2012. 2013 marked a return to fundamental estate planning; namely, using Wills, Revocable Trusts, Powers…

Q. My mother, Sally, is 67, has chronic depression, and is in the early stages of Alzheimer’s. In the past, Medicare only covered 50% of the costs of her psychological treatment for her depression. I feel like this is discrimination, since mental health treatment covered by Medicare is not on equal footing with other medical and surgical services. I hear, however, that the amount covered has gone up. How much does Medicare cover now for mental health outpatient services and what services are covered? Also, does Medicare pay for the care that is needed by people suffering from Alzheimer’s disease or other types of dementia?

A. For decades, Medicare has effectively discriminated against older adults with psychological conditions, such as depression and anxiety, because these conditions have received unequal treatment under Medicare. Medicare has paid a smaller share of the bill for therapy from psychiatrists, psychologists or clinical social workers than it did for medical services and has imposed strict lifetime limits on psychiatric hospital stays.

In 2008, Medicare covered 50% of the cost of psychological treatment, while in 2013, it covered 65%. Beginning in 2014, Medicare will pay 80% of its approved amount for certain outpatient mental health services. Payment kicks in once someone exhausts an annual deductible of $147 per year. Covered services include:

Individual and group therapy

Family counseling to help with your treatment

Tests to make sure you are getting the right care

Activity therapies, such as art, dance or music therapy

Occupational therapy

Training and education (such as training on how to inject a needed medication or education about your condition)

Substance abuse treatment

Laboratory tests

Prescription drugs that you cannot administer yourself, such as injections that a doctor must give you

Medicare will pay for the services of medical doctors (such as psychiatrists) who do not take Medicare (non-participating providers), but these doctors can charge you up to 15% above Medicare’s approved amount. Some states have stricter limits on how much doctors can charge. Find out more about Medicare’s Mental Health benefits on the Medicare.gov website.

Since its inception, Medicare has also effectively discriminated against older adults in that Medicare does not pay for the type of care that is needed by people suffering with certain diseases; specifically, Medicare (and, for that matter, private health insurance) does not pay for the care that is needed by people suffering from chronic illnesses such as Alzheimer’s disease or other types of dementia, or other brain diseases that cause a diminished ability to function without assistance from others. When a family has a loved one with one of these “wrong types of diseases,” that family must become officially “impoverished” under federal and state Medicaid rules in order to gain access to basic long-term care.

It is a tremendous shame that our country’s social policy essentially discriminates against those who get these “wrong types” of diseases. I submit that it is unfair for Medicare to provide full coverage for most diseases but force those with the “wrong type” of disease to go broke financially in order to gain access to the basic care needed – care which our society calls “long-term care” instead of “health care.” It should be no surprise to anyone that most knowledgeable families seek legal methods to preserve the efforts of a lifetime in order to protect themselves from our country’s unfair social policy.

If you have a loved one who is nearing the need for long-term care or already receiving long-term care, please contact The Law Firm of Evan H. Farr, P.C. as soon as possible at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to schedule your appointment for our no-cost consultation.

By John Dedon
In the estate tax world, 2013 ended in stark contrast to the frantic planning during 2012. 2013 marked a return to fundamental estate planning; namely, using Wills, Revocable Trusts, Powers…